UNIVERSITY OF CALIFORNIA
COOPERATIVE EXTENSION

NUTRITION PERSPECTIVES

Volume 29, No. 4
July/August 2004

TABLE OF CONTENTS

Judith Stern Receives Prestigious USDA Award
Mercury and Fish Consumption: Protecting Your Health!
Study: Children’s Weight Control
Ensuring the Safety of Dietary Supplements
California Leads Push to Better Regulate Dietary Supplements
Effect of Soy Protein Containing Isoflavones on Cognitive Function, Bone Mineral Density, and Plasma Lipids in Postmenopausal Women
Teens Lack Vitamin D
HHS Launches Campaign to Encourage New Mothers to Breastfeed Longer
The End of a (Paper) Era: FSP Needs New Name
Food Stamp Participation Increased to 23.8 Million Persons
Advisory Recommends individualized Hydration Strategy for Athletes
High-Calorie Diet May Lead to Prostate Enlargement
Community Food Security Coalition Celebrates Inclusion of Farm to Cafeteria In Child Nutrition Act
Antioxidants In Fruit Protect Eye Health
Is the Atkins Diet Bad for Bone?
Upcoming Conference:
Bruce Ames International Symposium on Nutritional Genomics

Subscription for NUTRITION PERSPECTIVES

Sheri Zidenberg-Cherr, PhD, Editor Department of Nutrition University of California Davis, CA 95616

NUTRITION PERSPECTIVES is prepared by Sheri Zidenberg-Cherr, PhD, Nutrition Specialist, Cristy Hathaway, and staff. It is designed to provide research-based information on ongoing nutrition and food-related programs. It is published bimonthly (six times annually) as a service of the University of California Cooperative Extension and the United States Department of Agriculture. Subscription to NUTRITION PERSPECTIVES is available from UC Cooperative Extension, Department of Nutrition, University of California, Davis, California. Cost is ten dollars ($10.00) for a one-year subscription. Subscriptions and questions or comments on articles may be addressed to: NUTRITION PERSPECTIVES, Department of Nutrition, University of California, Davis, CA 95616-5270. Phone (916)752-3387; FAX, (916) 752-8905.

Judith Stern Receives Prestigious USDA Award

Judith Stern, professor, Department of Nutrition, is the recipient of a 2004 Secretary's Honor Award, the most prestigious award presented by the US Department of Agriculture. The award recognizes outstanding contributions to agriculture, to the consumers of agricultural products, and to the ability of the USDA to serve rural America.

The award, presented in Washington D.C. on June 25, 2004, was given to Stern in the category of “Improving the Nation’s Nutrition and Health.” Carl Keen, nutrition department chair, said, “…Stern’s efforts have led to new health policy, particularly in the area of obesity and public awareness of nutrition’s importance.”

Source: CA&ES Currents; June 4, 2004; http://caes.ucdavis.edu/News/Currents/ SingleIssue.cfm?ID=145#1927.

Mercury and Fish Consumption: Protecting Your Health!

Eating fish can be an important part of a healthy diet. Fish is high in protein and an excellent source of omega-3 fatty acids, which helps reduce the risk of cardiovascular disease. However, recent studies have shown that eating too much fish may be harmful. So how do you weigh the risks and benefits of eating fish? The answer depends on what types of fish are being eaten, how much is eaten, and who’s eating it.

Mercury Concerns for Women and Children

Mercury poses health concerns for fetuses, infants, and children because it can adversely affect the development of the brain and the nervous system. It can build up in the body and be passed on to the developing fetus during pregnancy and to nursing infants through breast milk. Some studies have found that babies exposed in utero to a lot of mercury may learn and develop more slowly. Therefore, women who are pregnant or breastfeeding, or who may become pregnant, and children should always monitor their fish consumption in order to reduce their exposure to mercury.

National Mercury Health Advisory for Women and Children

So how much fish is safe to eat? The US Food and Drug Administration (FDA) and the US Environmental Protection Agency (EPA) recently issued a joint advisory for women of childbearing age and children when consuming fish. More information about this advisory can be found at www.epa.gov/ost/fish or at www.cfsan.fda.gov/seafood1.html.

The national advisory recommends:

• No consumption of four types of fish, shark, swordfish, king mackerel, and tilefish, regardless of its source.
• For fish purchased from stores or restaurants, women can eat up to 12 ounces each week (cooked weight).
• When choosing fish from stores or restaurants, women should always try to eat fish that are low in mercury such as shrimp, canned light tuna, wild salmon, scallops, farmed catfish, and pollock.
• Albacore (white) tuna and tuna steaks have more mercury than canned light tuna. Women should not eat more than 6 ounces (cooked weight) each week of these types of tuna and not eat any other fish that week.
• For fish that is caught by yourself, family, or friends, find out if there are any advisories for areas where fish were caught and follow them.

There are many fishing areas in California with advisories and not all these places have signs posted. Check with your local health department or the State Office of Environmental Health Hazard Assessment at 916-327-7319 or their website: www.oehha.ca.gov/fish.html.

If there are no advisories for areas where fish were caught, women should still limit consumption of fish caught by yourself, family, or friends to 6 ounces (cooked weight) each week and not eat any other fish that week.
Children should also follow this advice but be given smaller portions. It is advisable for women who are planning to become pregnant to follow the recommendations one year before becoming pregnant, if possible, in order to reduce body levels of mercury from fish already eaten.

Other Adults

What about other adults, women beyond their childbearing years and men? Many local advisories for fish caught by family and friends recommend limits for all populations so it is important to follow these. While the recent national advice doesn’t have specific guidelines for other adults, it is prudent for everyone to limit intake of fish known to have high levels of mercury like shark, tilefish, swordfish, and king mackerel. Too much mercury can also affect the nervous system in adults. Mild symptoms can include loss of sensation, tingling in hands and feet, tiredness, blurred vision, and memory loss.

Source: Environmental Health Investigations Branch, CA Department of Health Services, www.dhs.ca.gov/ps/deodc/ehib/index.htm.

Study: Children’s Weight Control

Children don’t eat the recommended food servings from the Food Guide Pyramid, they drink less milk and more soft drinks, and they eat larger portions of food, according to research from the University of Minnesota that studied the eating habits of 4,144 middle and high school students (1).

Researchers investigated the links between healthful and unhealthful ways children controlled their weight. Healthful weight-control meant eating more fruits and vegetables and fewer high-fat/sugar foods. Unhealthy weight-control behaviors were skipping meals, fasting, using food substitutes, and smoking. The researchers discovered that girls using unhealthful weight-control behaviors had poorer overall dietary intakes than girls reporting no weight-control behaviors or only healthful behaviors. Boys who used unhealthful weight-control behaviors, however, had about the same intakes as those using no weight-control behaviors or using only healthful behaviors, according to the story.

“The key to fostering lifelong healthy behavior, in children and through our lives, is education,” said Jeannie Moloo, registered dietitian and American Dietetic Association spokesperson, in a June 17 NewRX.com story. Go to www.adajournal.org to find the Journal of the American Dietetic Association story.

Reference:
Kelly Liebbe. Too Fat, Too Thin: Weight-Control Behaviors Among Girls and Boys. JADA; June 2004.
Source: Nutrition Week; June 28, 2004; 34:6.

Ensuring the Safety of Dietary Supplements

When taken appropriately, some dietary supplements have clear benefits. Folic acid lowers the risk of some birth defects. Calcium supplements can strengthen bones and help prevent osteoporosis. But some dietary supplements pose health risks. They may be improperly manufactured or handled, or their ingredients may cause harmful effects on the body.

Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), dietary supplements are regulated like foods. Unlike new drugs, dietary supplements don’t generally have to go through review by the Food and Drug Administration for safety and effectiveness or be “approved” before they can be marketed. But manufacturers must provide pre-market notice and evidence of safety for any supplements they plan to sell that contain dietary ingredients that were not on the market before DSHEA was passed.

The FDA evaluates the safety of dietary supplements after they are on the market primarily through research and adverse event monitoring. Those who market and make dietary supplements are responsible for ensuring that any claims are substantiated with adequate evidence, and they cannot claim that the dietary supplements will treat or cure any disease.

Monitoring Industry

The dietary supplement has changed a lot in the last decade. When DSHEA was passed, there were about 4,000 dietary supplements on the market. Now there are about 29,000 on the market, with another 1,000 new products introduced each year, according to a recent Institute of Medicine report that was sponsored by the FDA. “We have seen a huge growth in the industry over the last 10 years, including the introduction of products that seem far removed from the vitamins and minerals of the pre-DSHEA days, “ says Dr. Lester M. Crawford, Acting FDA Commiss-ioner. “Unlike most foods, some dietary supplements are pharmacol-ogically active.” When a substance is pharmacologically active, it can cause changes in the body. Such a substance could be toxic on its own or cause dangerous interactions with over-the-counter drugs.

Ephedra, which was often marketed for weight control and improved energy, was linked to cardiovascular problems, such as increased blood pressure and irregular heart rhythm. In the fist formal action to stop the sale of a dietary supplement since DSHEA was passed, the FDA banned ephedra last year. “This is an example of how we can get a dietary supplement off the market if we have solid scientific proof that it does more harm than good,” Crawford says.

Manufacturers and retailers can make claims about the impact of dietary supplements on the structure of function of the body, but these claims must be truthful. An example of such a claim is “calcium builds strong bones.” The FDA plans to issue guidance for what data substantiates these types of claims. The agency has worked closely with the Federal Trade Commission to aggressively enforce the law against dietary supplements that are labeled with fraudulent health claims. In April 2004, the FDA sent warning letters to 16 firms, asking them to stop making false claims for weight loss.

From November 2003 to April 2004, the FDA inspected 180 domestic dietary supplement manufacturers, sent 119 warning letters to dietary supplement distributors, refused entry to 1,171 foreign shipments of dietary supplements, and seized or supervised the voluntary destruction of almost $18 million worth of mislabeled or adulterated dietary supplement products.

In March 2004, the FDA requested the 23 companies stop distributing dietary supplements containing androstenedione, also know as “andro.” Widely marketed to athletes and body builders, androstenedione has been touted as a way to increase muscle growth and reduce fat. However, it acts like a steroid in the body and increases the risk of serious diseases. For example, women who use these products may be at an increased risk for breast cancer and endometrial cancer. Children who use these products are at risk of early onset of puberty and of premature cessation of bone growth.

Additionally, the FDA is developing regulations for industry on good manufacturing and handling of dietary supplements to ensure that consumers are provided with high-quality dietary supplements.

“The Good Manufacturing Practice (GMP) regulation is the linchpin for properly regulating dietary supplements,” Crawford says. “It gives FDA benchmarks for regulating dietary supplements and it gives clear instructions to the industry on how to manufacture products that meet rigorous quality standards.”
Continuing Research

Crawford says that these initiatives are an important part of the agency’s science-based approach to regulating dietary supplements. He also notes that the FDA was pleased to welcome Barbara O. Schneeman, PhD, as the new director of the Office of Nutritional Products, Labeling, and Dietary Supplements, part of the FDA’s Center for Food Safety and Applied Nutrition. Schneeman has an extensive background in nutrition science and has served on the faculty of the University of California, Davis, since 1976.

The FDA continues to collaborate with federal research partners at the National Institutes of Health and other organizations to gather evidence about the safety and effectiveness of dietary supplements. “In evaluating dietary supplements, we look at scientific information from a range of sources,” Crawford says, “including published-research, evidence-based reports, and data about the pharmacology or toxicology of a compound.” Crawford notes that the agency has particular interest in gathering safety data about certain dietary supplements suspected to pose human health risks, including:

an ephedra substitute called Citrus aurantium, also known as bitter orange, which may present health risks similar to ephedra.
usnic acid, marketed for weight loss and linked to liver damage
kava, a botanical ingredient that has caused liver failure
pyrrolizide alkaloids, which are found in some plants and have been shown to have toxic effects that can cause liver damage.

The FDA recommends that consumers talk with a health care provider before using a dietary supplement. People who think they have been harmed by a dietary supplement should contact their health providers, and also report it to the FDA’s MedWatch program by calling (800) FDA-1088 (332-1088), or visiting www.fda.gov/medwatch/.

Source: Meadows, Michelle. FDA Consumer; 2004 July-August; 38:10-11.

California Leads Push to Better Regulate Dietary Supplements

Although dietary supplement industry members want to leave the Dietary Supplement Health and Education Act of 1994 (DSHEA) as is, many groups support proposed changes at federal and state levels to better regulate the supplements and protect consumers. Two new bills have been proposed in Congress to enhance FDA authority and to require manufacturers to report adverse events or illness caused by supplements, but one state is riding the crest of dietary supplement legislation.

In California, three dietary supplement bills have passed the House and may be signed into law. The first would require California manufacturers to inform the California Department of Health Services (DHS) of any adverse reports from dietary supplements. The second prohibits the sale of performance-enhancing dietary supplements to minors.

The third California bill would require high school coaches to take a course on the dangers of supplements, prohibit children from taking supplements, and prohibit schools from seeking sponsorships from supplement manufacturers. When a student is suspected of taking a supplement, the bill would require that the school test that student for traces of the product in the body. The bill also directs the California DHS to develop a list of banned substances.

Elisa Odabashian, a spokesperson for the Consumers Union, a nonprofit publisher of consumer reports, says her organization is concerned that the DSHEA doesn’t require reporting of adverse events. Currently, the FDA must prove that a dietary supplement is unsafe before removing it from the market. “This makes for weak regulation of the dietary supplement industry,” says Odabashian.

California, a large part of the $18.8 billion annual supplement market, banned the sale of ephedra several months before it was banned nationwide by the FDA. “Our position is that a variety of dietary supplements are probably safe. A dozen or so aren’t safe,” says Odabashian. “When consumers go into a store, their assumption is that somebody has overseen their safety, and that’s not necessarily true.” Supplements makers are currently prevented only from claiming that their product will cure a disease. “You could be taking anything, and there’s no proof that it will do what it claims it will,” says Odabashian.

A spokesperson from the American Herbal Products Association (AHPA), a national herbal products trade association, says current supplement legislation is fine as it stands. However the spokesperson agrees that manufacturers should report adverse effects. “We aren’t hurting people. This is an incredibly safe product category.” Go to www.consumers union.org/pub/core_product_safety/001171.html to read more.

Source: Nutrition Week; June 28, 2004; 34:2.

Effect of Soy Protein Containing Isoflavones on Cognitive Function, Bone Mineral Density, and Plasma Lipids in Postmenopausal Women

Regular intake of soy protein is thought to be partially responsible for the lower rates of heart disease, stroke, and cancer observed in Eastern populations. Due to recent concerns that have been raised about the use of hormone replacement therapy, many researchers are looking to soy as a possible natural alternative to prevent some of the symptoms associated with menopause such as a decline in cognitive function and bone mineral density and an increase in total and LDL cholesterol. The aim of the investigation described below was to determine the effect of soy protein supplements on cognitive function, bone mineral density, and plasma lipids in postmenopausal women between 60 and 75 years of age. Two hundred and two women were recruited and randomly assigned to receive either 25.6 grams of soy protein powder or a placebo containing an equal amount of milk protein. The participants were asked to consume the supplement daily for one year by mixing it into a food or beverage. At completion of the trial, there was no statistical difference between the two groups in cognitive function, bone mineral density, or plasma lipids. The results of this investigation suggest that soy protein does not have beneficial effects on symptoms associated with menopause.

Adapted from: JAMA; July 7, 2004; 292(1):65-74.
Karrie Heneman, PhD, Nutrition Department, University of California, Davis.

Teens Lack Vitamin D

Many US teens lack vitamin D, a vitamin crucial to bone health, according to an American School Food Service Association (ASFSA) press release. A dearth of D is caused when people don’t get enough sunlight, don’t eat enough foods that contain vitamin D, or have kidney or gastrointestinal problems, according to the National Institutes of Health. Research published in the June Journal of Pediatric and Adolescent Archives found that approximately 42% of adolescents in a study were vitamin D deficient.

Levels of the vitamin varied according to season, the adolescents’ ethnicity, how much milk and juice they drank, body mass index, and how much they exercised. African American teenagers had the highest prevalence of D deficiency; and winter caused the worst D depletion, according to researchers. To read ASFSA’s press release, go to www.asfsa.org/newsroom/sfsnews/vitaminddef.asp. To read the study abstract, go to http://archpedi.ama-assn.org.

Adapted from: Nutrition Week. July 12, 2004; XXXIV(14):6.

HHS Launches Campaign to Encourage New Mothers to Breastfeed Longer

The US Department of Health and Human Services (HHS’) Office on Women’s Health (OWH) and the Advertising Council launched a national public service announcement (PSA) campaign on June 4, 2004, to promote breastfeeding awareness.

Recent studies show that breastfed babies are less likely to develop ear infections, respiratory illness, and diarrhea and may have reduced risk for childhood obesity. The United States has one of the lowest rates of breastfeeding in the world. Although most new mothers do breastfeed, more than half switch to formula by six months.

The OWH’s campaign encourages first-time mothers to breastfeed exclusively for at least six months. Currently, 29% of mothers breastfeed for at least six months. OWH hopes to increase the number of mothers who breastfeed to 75% by 2010 and encourage 50% more to continue breastfeeding beyond six months.

“These new PSAs speak to parents clearly about the consequences of not breastfeeding, which may encourage more mothers…to breastfeed exclusively for six months,” says Acting Secretary of Health at HHS Cristina Beato, MD. The PSAs will target the general market as well as the African-American community, where rates of breastfeeding are lowest.

Lawrence M. Gartner, MD, FAAP, chair of the section committee on breastfeeding for the American Academy of Pediatrics (AAP), says human milk ensures children’s best development, although formula can provide basic nutrition. “Formulas are better today than they were 30-40 years ago and will assure adequate growth of babies, not optimal,” says Gartner. Formula-fed babies have a greater risk of obesity; breastfeeding, however, leads to some later protections from it, according to Gartner. “Formula-fed babies also have a 20% higher infant mortality rate,” he added.

La Leche League Interna-tional, an organization that promotes breastfeeding, lauded the campaign. “I hope the campaign will change our culture from bottle to breast when people find out how important breastfeeding is,” says a spokesperson for the group. Women discontinue breastfeeding by six months partially because hospitals send mothers home with formula packs, which sends the message that they don’t have to or shouldn’t breastfeed exclusively, according to the La Leche League.

A spokesperson from MeadJohnson, which manufactures the leading infant formula Enfamil, objects to some of the campaign’s imagery, particularly a television spot depicting a logrolling contest between two pregnant women.

“We really have no issues with what the ads say. Mothers have long agreed that breastfeeding is best for their babies. We are disappointed with the graphics. Pregnancy is a beautiful time in a woman’s life, and I would personally like to see more appropriate imagery,” the spokesperson says. “I think the ads portray a risk that isn’t there. There are no risks in feeding an infant formula.” View the campaign at www.adcouncil.org.

Source: Nutrition Week; June 28, 2004; XXXIV(12):1.

The End of a (Paper) Era: FSP Needs New Name

The US Department of Agriculture (USDA) announced June 22, 2004 that the entire United States now provides Food Stamp Program (FSP) benefits with electronic benefit (EBT) cards. The switch from paper food stamps to plastic cards prompted USDA to put out a call for a new name for the FSP. The FSP enables more than 23 million low-income participants to buy food each month.

The EBT card announcement wasn’t news to everyone; many states already use the cards. The first card was tested in 1984 in Reading, PA, according to a USDA press release. Congress mandated EBT in 1996, when 14 states had EBT. In the past eight years, 40 states switched to the paperless system. For example, Massachusetts has used the technology since 1997. According to the state’s Executive Office of Health and Human Services, EBT cards have been an effective way to direct benefits to recipients. “It has helped reduce the stigma that was often associated with food stamps,” says an office spokes-person. “It has been a boon for both grocery stores and our recipients.”

“It mainlined the [food assistance] recipient community into the rest of electronic commerce,” says Doug O’Brien, vice president for public policy and research for the anti-hunger advocacy organization Second Harvest.

The cards, which look like ATM cards, have several advantages over the paper version. For one, they reduce fraud and simplify transactions for the grocery industry, which no longer has to bundle paper coupons. “This is a great success as far as practical usage,” says O’Brien.

The cards also improve accountability by tracing each transaction and ensuring that benefits are spent only at authorized stores. “Many states use this technology to deliver benefits from other federal programs such as Temporary Assistance to Needy Families, Medicaid, and Child Care,” said the USDA press release. The EBT card has also lessened the occurrence of administrative errors. According to USDA Agriculture Secretary Ann M. Veneman, program accuracy has improved by 25% over the past three years. This resulted in half a billion dollars fewer payments made in error and $173 million paid to eligible clients instead.

Perhaps the biggest challenge in the EBT age will be to make people aware that they are qualified for the FSP and can enroll. While 80% are eligible, only 20% receive food stamps. And for many, it’s still too difficult to apply to the program. According to the Red Tape Divide, a 2001 report from Second Harvest, some states have 30-page applications for FSP, and the application process required an average of two visits.

O’Brien suggests that the FSP should be renamed the National Food Security Program. “Prior to Social Security, we had a poverty level of one-third with the elderly. Today, it’s less that 10%. FSP is like the Social Security program; it provides a basic assurance of food security,” he said.

To comment on renaming the FSP, write to John Knaus, chief, Program Design Branch, Program Development Division, Food and Nutrition Service, US Department of Agriculture, 3101 Park Center Drive, Alexandria, VA, 22302; fas 703/305-2486; or e-mail john.knaus@fns.usda.gov on or before August 23. Submissions will be shared with Congress.

From: Nutrition Week. 2004 July 12; 34:1.

Source: Nutrition Week. July 12, 2004; XXXIV(14):1.

Food Stamp Participation Increased to 23.8 Million Persons

Participation in the Food Stamp Program (FSP) in March increased by 299,077 people from the previous month to 23,815,664. The increase was due in part to continuing high rates of joblessness, states improving access to the program, and the effects of the food stamp reauthorization implementation. Research suggests, however, that nearly one in four eligible people do not receive food stamp benefits. Each federal food stamp dollar is estimated to produce nearly $2 in economic activity.

The March level of FSP participation represented a rise of more than 2.8 million people since the previous year and nearly 6.6 million people since July 2000 when participation reached a 10-year low. Caseloads dropped between 1998 and 1999 as the economy improved and many states failed to get food stamps to low-income families who had left cash welfare for low-paid work. Caseloads then stabilized and began rising in 2000.

Increases in participation since 2001 probably have been driven by improved access to the program in states, including access most recently for legal immigrants, and by the weakened economy. Participation has risen in 37 of the past 42 months. Participation in March rose in 49 states and the District of Columbia compared to March 2003. Below are the states with the largest percent change in food stamp participation in the past year.

Food Stamp Program: One-year participation change as of May 25

Source: Food Research and Actions Center’s Food Stamp Program: 1-Year Participation Change. www.frac.org/html.news/1_Yr_Change.html

Source: Nutrition Week; June 28, 2004; XXXIV(12):8.

Advisory Recommends Individualized Hydration Strategy for Athletes

Who should be concerned about hydration?

Maintaining proper hydration is important for everyone; however, athletes, especially those competing for four or more hours, must pay special attention to their hydration status.

What are the current recommendations regarding fluid intake during exercise?

USA Track and Field (USATF) recommends that athletes consume 100 percent of fluids lost to sweat during exercise and should consume no more than 800 mL of fluid in an hour. Sports drinks containing electrolytes are the preferred form of hydration for endurance athletes. The USATF self-testing Program for Optimal Hydration can be used to help athletes determine the amount of fluid needed for them to maintain proper hydration found online at: http://www.usatf.org.

Why are the hydration guidelines being updated?

Previous recommendations to “stay ahead of your thirst” and to “drink as much fluid as possible during competition” have been called into question by an increase in the number of deaths due to hyponatremia. Hyponatremia, a condition that can be life threatening, occurs when an athlete consumes large amounts of water without adequately replacing sodium and other electrolytes that are lost through sweat during intense exercise.

What are the symptoms of hyponatremia?

Nausea, vomiting, disorientation, seizures, low plasma sodium (130mmol/L), a progressively worsening headache, and swelling of the hands and feet are all symptoms of hyponatremia.

Adapted from: Nutrition & the M.D., June 2004; 30(6):4-5.
Karrie Heneman, PhD. Nutrition Department, University of California, Davis.

High-Calorie Diet May Lead to Prostate Enlargement

Although prostate cancer is the most common cancer in American men, prostate enlargement affects half of all men over age 50. Benign prostatic hyperplasia (BHP), or prostate enlargement, does not indicate prostate cancer risk by itself, but it occurs when normal prostate cells grow abnormally, and therefore is considered a possible risk factor. The risk factors for BPH are age and family history.

Recent studies link high caloric intake, as well as diets high in protein and some polyunsaturated fats, with prostate enlargement. Researchers suggest that excess calorie consumption could somehow directly stimulate prostate enlargement through excess body fat and its effects on hormone levels. This is an active field for research at present, so stay tuned.

Community Food Security Coalition Celebrates Inclusion of Farm to Cafeteria In Child Nutrition Act

The Community Food Security Coalition (CFSC) celebrates the inclusion of a new program to bring locally grown food into school meals in the Child Nutrition and WIC Reauthorization Act, recently passed by Congress and signed into law by the President. “Access to Local Foods and School Gardens” (Section 122) builds on the success of over 400 farm to cafeteria programs in 23 states that not only feed children fresh, local food, but gets them excited about it.
“Access to Local Food and School Gardens” is based on earlier legislation known as the Farm to Cafeteria Projects Act. Senators Patrick Leahy (D-VT) and Arlen Specter (R-PA) championed this legislation in the Senate, as did Representatives Fred Upton (R-MI) and Ron Kind (D-WI) in the House.

Schools may compete for grant funds to help school food service personnel develop procurement relationships with local farmers and the program also supports agriculture-based nutrition education, such as school gardens, to teach students where their food comes from.

Kathy Ozer, executive director of the National Family Farm Coalition notes how this legislation also benefits farmers. “Family farmers will gain access to an important new market, their local schools, while students better understand the connections between farming and food.”

The CFSC President Sharon Thornberry added, “This victory is a major step forward for restoring high quality nutritious food to our nation's school meal programs and supporting farmers through direct purchase of their products in their own communities. We urge Congress to appropriate funds to make this program a reality in 2005.”

The Community Food Security Coalition, with over 325 member organizations across the country, advocates for projects that link anti-hunger, nutrition, and agriculture issues. At the federal level, CFSC has been instrumental in the creation and expansion of the Community Food Projects Competitive Grant Program.

Source: Hunger and Environmental Nutrition Dietetic Practice Group of the American Dietetic Association Press Release; July 1, 2004.

Antioxidants In Fruit Protect Eye Health

An apple a day may really keep the doctor away, especially in those over 65 who are concerned about vision loss. A new study in the Archives of Ophthalmology shows that antioxidants and carotenoids, which are responsible for the yellow, orange, and red pigments found in fruit, may prevent age-related maculopathy (ARM), which is the leading cause of vision loss in people 65 and older (1).

The researchers found that fruit consumption was inversely associated with risk of ARM, and participants who ate 3 or more servings per day of fruit had a 36% lower risk of ARM compared to participants who reported eating less than 1.5 servings per day. These findings were similar for men and women, and they were not seen in those who consumed a similar amount of vegetables.

Reference:
Cho E, Seddon JM, Rosner B; Willett WC, and Hankinson SE. Prospective Study of Intake of Fruits, Vegetables, Vitamins, and Carotenoids and Risk of Age-Related Maculopathy. Arch Ophthalmol, June 2004; 122: 883-892.
Source: Nutrition Today; July/August; 39(4): 152.

Is the Atkins Diet Bad for Bone?

Researchers have long sought to determine whether the relatively high intakes of protein typical in American diets contribute to an increased risk of osteoporosis. The question has become even more urgent in recent years with the rise of the low-carb, high-protein diet trend led by Dr. Atkins. While the literature shows some movement toward consensus on the role of protein in bone health, this has not necessarily led to agreement on the impact of the Atkins diet.

“As the research in this area has evolved, more and more investigators are coming around to the idea that high-protein diets are not bad for bone,” says Jane Kerstetter, PhD, associate professor at the University of Connecticut School of Allied Health in Storrs, Connecticut. “But it is important to understand that when we say ‘high-protein diets,’ we are not talking about the Atkins diet,” Kerstetter cautioned. “These diets should not be considered the same.”

Kerstetter is a leading researcher in the field and has conducted numerous studies comparing the effects of low-, medium-, and high-protein diets on markers of bone health. She has been a key proponent of the view that diets with higher protein intakes do not contribute to osteoporosis and that such diets may in fact be protective. However, she says that this line of thinking does not yet extend to the high-protein Atkins diet.

The reason, Kerstetter explains, is that the Atkins diet introduces many other variables, besides high protein intake, whose impacts on bone health have not been rigorously studied. “In addition to the increase in protein, you’ve got the effects of a very low carbohydrate intake, the effects of metabolic acidosis, the effects of a high-fat diet, and the effects of weight loss, any of which could potentially affect bone health.”

Calcium Source Disputed

The potential bone-thinning effects of high-protein diets are based on laboratory research. Numerous investigations have confirmed that diets high in protein result in an increased renal acid load. Researchers have hypothesized that to neutralize this acid load, the body would draw on its calcium reserves from bone, resulting in increased urinary calcium excretion and decreased bone mineral density (BMD). “The traditional view was that the higher the protein content of the diet, the higher the acid load would be, and the more buffering that would be required from bone,” Kerstetter explains.

She says that although this model seems to hold true on the cellular level, intervention studies, for the most part, have failed to support it: “When you take it to the level of real human beings eating a high-protein diet, the data do not show that their bones dissolve away.” One potentially important recent finding is that intestinal calcium absorption may fluctuate in response to changes in dietary protein. Using newer, more sensitive laboratory techniques, Kerstetter’s research team has observed that intestinal calcium absorption rises in concert with increased protein intake in four-day intervention studies. These findings suggest that the increase in urinary calcium excretion produced by high-protein diets could be due to a rise in the amount of calcium absorbed, not an increase in bone resorption. With low protein intakes, meanwhile, calcium absorption is acutely reduced, and secondary hyperparathyroidism develops, according to Kerstetter (1).

These findings contradict those of many previous calcium balance studies, which have found no change in calcium absorption in response to varying dietary protein. If confirmed, however, these new results could have far-reaching implications. They suggest that the high-protein diets enjoyed by many are probably not harmful to bone, and in fact, could potentially be helpful because they cause an increase in calcium absorption. They further indicate that low protein intakes, far from being protective of bone, may impair calcium absorption, induce secondary hyperparathyroidism, and result in decreased BMD.

Epidemiologic Data Mixed

This new view of protein’s role in bone health is supported to some degree by the epidemiologic data. Most studies that have assessed BMD as the primary endpoint report that the highest BMD is seen in those groups that consume the most protein. Furthermore, protein intakes seem to affect the loss of bone over a period of time. For example, a prospective study of 615 elderly men and women from the Framingham cohort found that those in the lowest quartile of protein intake at baseline had the most BMD loss after four years, while those in the highest quartile had the least BMD deterioration (2).

There is somewhat less clarity in the data when the primary outcome is fracture rates, however. Most studies of fracture risk have reported increasing fracture rates as protein intake increases. But a large new case-control study of older men and women from Utah has reported decreasing fracture risk through increasing quartiles of protein intake in participants aged 50 to 69. No associations were observed among participants aged 70-89, suggesting that age may modify the interaction between protein intake and hip fracture risk (3).

Kerstetter believes that this new study, which was well designed and carefully controlled, presents the most accurate assessment to date of the relationship between protein intake and fracture risk. Nevertheless, more research will probably be needed before these results are widely accepted as conclusive.

Little Evidence on Atkins

No long-term intervention studies have tested the effects of Atkins-type weight loss diets on bone health, but a report from a recent short-term study gives some cause for concern. Investigators estimate that the Atkins diet induced a 130 mg/d net calcium deficit and increased the risk of bone loss over time (4).

The finding from this small, uncontrolled study are not definitive, and it will likely be many more years before we can say with any certainty what the Atkins diet does to bone. In the meantime, what can clinicians tell their patients who have adopted a low-carb lifestyle?

“I would say to them, ‘Look, if you’re going to go on one of these diets, be absolutely sure you get enough calcium and vitamin D,’” Kerstetter says. She notes that without sufficient intake of these nutrients, it is unlikely that any diet will be good for skeletal health. “But if you do maintain the recommended intake of vitamin D and calcium, there’s a good chance that the diet’s harmful effects on bone, whatever they might be, will be minimized.”

References:
Kerstetter JE, O'Brien KO, and Insogna KL. Low Protein Intake: the Impact on Calcium and Bone Homeostasis in Humans. J Nutr; 2003; 133(3): 855S-861S.
Hannan MT, Tucker KL, Dawson-Hughes B, et al. Effect of Dietary Protein on Bone Loss in Elderly Men and Women: The Framingham Osteoporosis Study. J Bone Miner Res; 2000; 15(12): 2504-2512.
Wengreen HJ, Munger RG, Cutler DR, Corcoran CD, Zhang J, and Sassano NE. Dietary Protein Intake and Risk of Osteoporotic Hip Fracture in Elderly Residents of Utah. J Bone Miner Res; 2004; 19(4): 537-45.
Reddy ST, Wang CY, Sakhaee K, Brinkley L, and Pak CY. Effect of low-carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. Am J Kidney Dis; 2002 Aug; 40(2):265-74.
Source: Nutrition & the MD; July 2004; 30(7): 3-5.

Upcoming Conference:

Bruce Ames International Symposium on Nutritional Genomics

October 22-24, 2004
University of California, Davis

The Bruce Ames International Symposium on Nutritional Genomics will be held Friday October 22 to Sunday October 24, 2004 on the University of California, Davis campus, Davis, California. The symposium will provide opportunities for students, researchers, educators and policy makers to communicate and interact with representatives from the food and pharma industries and the health care professions in the pleasant and comfortable surrounding provided by the UC Davis campus. Nutritional genomics (also called “nutrigenomics”) is the latest “omic” science to emerge from the post genomic era. Nutrigenomics combines good nutrition, genomics and medicine to examine how nutrients and other dietary constituents act on common genetic variation to promote health or cause disease. Nutrigenomic views food as more than a source of energy, but rather as complex dietary components, some having bioactive, therapeutic or chemopreventive properties. Nutrigenomics seeks to establish a molecular understanding for how common dietary constituents affect human health by altering the expression and/or structure of genes. The fundamental precepts of nutrigenomics can be summarized in the following five tenets:

• Poor diet can be a serious risk factor for a number of diseases.
• Common dietary chemicals can alter, either directly or indirectly, the expression or structure of genes.
• The degree to which diet influences the balance between disease and health can depend on an individual's genetic makeup.
• Some diet-regulated genes (and their normal, common variants) may play a role in the onset, incidence, progression, and/or severity of chronic diseases.
• Dietary intervention based on knowledge of nutritional requirements, nutritional status, and genotype (i.e. “personalized nutrition”) can be used to prevent, mitigate or treat chronic disease.

Just as pharmacogenomics has led to the concept of “personalized medicine” and “designer drugs”, so will the new field of nutritional genomics open the way for “personalized nutrition.” With a better understanding of how our unique genetic makeup affects the way we respond to our nutritional environment, we should be able to better manage health and reduce the risk of disease.

Ways to Register:
Mail or fax completed forms with full payment to:
Conference & Event Services
Attn: Nutrigenomics
University of California
One Shields Avenue
442 Memorial Union
Davis, CA 95616
USA
Fax: 530.752.5791
Or register on-line, with a credit card at:
http://www.cevs.ucdavis.edu/Cofred/Public/Reg/Index.cfm?confid=202.

[Online source]: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=202.

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